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BACK BAY MD LLC
NPI 1972460244
Clinic/Center in Malden, MA

Active since January 07, 2026
578 MAIN ST UNIT B5, MALDEN, MA 02148(857) 200-8997 Get Directions Write a Review

NPPES record last updated: January 7, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Back Bay Md Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BACK BAY MD LLC (NPI 1972460244) is a healthcare organization registered as a clinic/center in Malden, Massachusetts and active in the NPI registry since January 2026. The organization lists Luis Henkel, Owner And Medical Director, as its authorized official.

NPPES Registry Identity

NPI1972460244
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameBACK BAY MD LLC
Location Address578 MAIN ST UNIT B5Malden, MA 02148-4094
Mailing Address578 Main St Unit B5Malden, MA 02148-4094 · (857) 200-8997
Phone(857) 200-8997
Organization SubpartNo
Authorized OfficialLuis HenkelOwner And Medical Director · (857) 200-8997
Enumeration DateJanuary 7, 2026
NPPES CertifiedJanuary 7, 2026
✔ NPI 1972460244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
578 MAIN ST UNIT B5, Malden, MA 02148
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 22D2309338

Back Bay MD, LLC · Malden, MA
Expired · Aug 12, 2026
CLIA Number22D2309338
Laboratory TypePhysician Office
Certificate Effective DateAugust 13, 2024
Certificate Expiration DateAugust 12, 2026
Laboratory DirectorDr. Luis M. Henkel
Laboratory Phone(857) 200-8997
Laboratory LocationBack Bay MD, LLC578 Main Street, Unit B5, Malden, MA 02148
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Back Bay MD LLC's NPI number?

The NPI number for Back Bay MD LLC is 1972460244. It was assigned to this organization in the NPPES registry on January 7, 2026.

Where is Back Bay MD LLC located?

Back Bay MD LLC is located at 578 Main St Unit B5, Malden, MA 02148. The listed phone number is (857) 200-8997.

What is Back Bay MD LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Back Bay MD LLC was last updated on January 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.